Samuel Loewenberg, reporting on poor health in The Lancet in 2005, states that poverty is the reason for the 10 x higher death rate in the favelas in Rio, compared to wealthier neighborhoods. Open sewers, a breeding ground for disease, run through some areas, attracting rats. Sewage overflows into people's homes in the rainy season. But health care workers in community health clinics know that treating disease is not enough to stem the tide of untimely death in the favelas. 1.2 million people live in the slums on less than $2 per day. Favela residents are denied basic services - health care, education, space for recreation. Malnutrition, diarrhea, pneumonia, skin diseases, stroke and hypertension are rampant.

If you have seen the movie, City of God, you have some glimpse into the life of the youth of the favelas. Directed by Fernando Mereilles and Katia Lund, the movie employs actual children from the slums of Rio to act in the film. 4000 kids died from gunshot wounds in 2004 - ten times more than died in the Israeli-Palestinian conflict. "...public health is not only a question of disease but of bullets..." . Violence keeps teachers, health care workers and even the police away - unless they fly in by helicopter during military type raids - which explains Santa's mishap.

Poverty, discrimination, gangs and drugs. Too many children are caught in the crossfire. We need to resolve the issues of poverty and health disparities and give them better options, and hope for their future. For those who want to get up close and personal with the favela experience, there is The Little Slum Inn or Pousada Favelinha for $35 a night.

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